A systematic review of multicomponent vs. single-component training programs for fall prevention in older adults

Background Falls among adults aged 60 years and older often result in serious injury, yet studies evaluating single-component exercise interventions have not been directly compared with those incorporating multiple modalities. This review set out to assess whether multicomponentl training programs combining strength, balance, and aerobic exercises are more effective at preventing falls in older adults than single-component regimens. Methods A systematic search of PubMed, Scopus, Web of Science and EBSCO yielded 284 records, of which six randomized controlled trials ( n = 40–670; age range 60–80 years) met inclusion criteria. All interventions lasted at least 6 weeks. We narratively synthesized data on functional outcomes (Timed Up and Go TUG, Star Excursion Bal-ance Test SEBT, 30-Second Chair Stand CS-30, gait speed), physiological measures (VO₂max, lean body mass, bone mineral density) and fall incidence rate ratios (IRR). Results Multicomponent programs surpassed single-component interventions, producing a ~ 1-s faster TUG, an 8–20% improvement in SEBT reach, and a 55% increase in CS-30 repetitions. Physiologically, VO₂max rose by 154 mL/min, lean body mass by 1.2 kg, and BMD by 0.02 g/cm 2 . The greatest reduction in fall risk was observed in the Tai Ji Quan group (IRR 0.42), compared with 0.60 in the standard multicomponent program. Conclusion Protocol heterogeneity precluded quantitative meta-analysis. Based on limited and heterogeneous data from six RCTs, MULTI programs appear to improve selected functional parameters and reduce fall risk; however, the effectiveness of the single-component UNI program (Tai Ji Quan) was comparable to—or even greater than—that of MULTI in reducing actual falls. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251045931 .